| NPI | 1063113660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 37150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000242729) |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2024-11-05 |