| NPI | 1497384564 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 32430) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO APN.0995437-NP) | 
| 207Q00000X Family Medicine (Licence: TN 32430) | |
| Enumeration Date | 2020-04-02 | 
| Last Update Date | 2023-05-10 |