| NPI | 1053874073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25718) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002381) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A162079) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 113617) | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2023-04-24 |