| NPI | 1639769623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 32747) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000239353) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2023-01-31 |