| NPI | 1104488626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187638) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 26026) |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2023-07-27 |