| NPI | 1790266401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24047) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2023-09-17 |