| NPI | 1417654260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33260) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186205) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-10-31 |