| NPI | 1699249060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25390) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177149) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2025-05-09 |