| NPI | 1629556196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24454) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178261) |
| 207Q00000X Family Medicine (Licence: TN 0000024454) | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2025-09-24 |