| NPI | 1760591523 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 6557)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 87969)  | 
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2023-03-20 |