| NPI | 1053400788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 8454) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 8454) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-06-15 |