| NPI | 1912760042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33895) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021120) |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-05-28 |