| NPI | 1891364774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 66319) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29682) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2024-04-17 |