| NPI | 1659864650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 10456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185100) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-09-15 |