| NPI | 1750055729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024181599) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 29768) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2025-10-16 |