| NPI | 1356931042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000030399) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9492484) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2022-03-09 |