| NPI | 1003209982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000019649) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2017-07-25 |