| NPI | 1518778752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 37991) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024192442) |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-04-13 |