| NPI | 1134666191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188331) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22121) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2025-08-27 |