| NPI | 1710593462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 32815) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 904503) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2025-01-22 |