| NPI | 1700616414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190898) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 36787) |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-12-13 |