| NPI | 1285129544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000024226) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176016) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2022-01-03 |