| NPI | 1104603653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 34665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 906261) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2024-04-17 |