| NPI | 1669137246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024187952) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 4040855) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 30653) | |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2025-06-12 |