| NPI | 1972366375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-265881) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 274243) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 37338) | |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2025-10-04 |