| NPI | 1063111672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000036026) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000243667) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2025-01-16 |