| NPI | 1053710921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 167866) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9368555) | |
| 163W00000X Registered Nurse (Licence: FL RN 9368555) | |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2020-10-16 |