| NPI | 1003256496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000017457) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS A810519) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2014-08-08 |