| NPI | 1740680776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18731) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184633) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2025-02-05 |