| NPI | 1639556558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19912) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189519) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2024-06-07 |