| NPI | 1609522804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 31324) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 31324) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 31324) | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-08-14 |