| NPI | 1639942436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188546) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 34858) |
| 363L00000X Nurse Practitioner (Licence: VA 0024188546) | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2025-10-21 |