| NPI | 1790237683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 22343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9363644) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22343) | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2022-01-04 |