| NPI | 1104686179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 36196) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 206767) |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-07-22 |