| NPI | 1326505330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25461) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015458) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2025-05-13 |