| NPI | 1134863137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 33803) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 68146) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2023-10-13 |