| NPI | 1669136248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30875) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 904852) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2022-01-18 |