| NPI | 1124646682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 27928) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 209274) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TN 27928) | |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2024-07-29 |