| NPI | 1225678741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN F08191285) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 54077) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2026-05-19 |