| NPI | 1619743424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 35171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 906883) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2025-01-22 |