| NPI | 1003800616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 7153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN RN104363) |
| 363L00000X Nurse Practitioner (Licence: TN APN0000007153) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2019-01-18 |