| NPI | 1912649013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000031448) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 31448) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2025-12-05 |