| NPI | 1912599192 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 29175)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 000000000)  | 
| Enumeration Date | 2021-02-09 | 
| Last Update Date | 2023-08-23 |