| NPI | 1336853480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 35985) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 351078) |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2024-05-02 |