| NPI | 1649035510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 40432) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4057217) |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2026-05-15 |