| NPI | 1962423368 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170497)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 6609)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: TN RN089429)  | |
| Enumeration Date | 2006-07-21 | 
| Last Update Date | 2025-03-03 |