| NPI | 1225627748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28953) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180735) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2022-12-08 |