| NPI | 1053899534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25036) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 200724) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2019-10-07 |