| NPI | 1720822174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 36631) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190826) |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2025-03-21 |