| NPI | 1902390636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 0000034190) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000207646) |
| 207Q00000X Family Medicine (Licence: TN 0000034190) | |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2024-02-22 |