| NPI | 1871058263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25202) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184785) |
| Enumeration Date | 2019-02-10 |
| Last Update Date | 2022-10-18 |