| NPI | 1790646024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 40542) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1655633) |
| Enumeration Date | 2025-11-18 |
| Last Update Date | 2026-02-12 |