| NPI | 1962979617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25110) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 25110) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2023-08-08 |