| NPI | 1639854136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 34297) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 199473) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-09-19 |