| NPI | 1962126128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 2021104533) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 32772) |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2025-08-14 |