| NPI | 1790113595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 18127) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 18127) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2025-12-01 |