| NPI | 1619610961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 31248) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 31248) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |