| NPI | 1932582012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 20964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173049) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 185995) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-01-27 |