| NPI | 1063498707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 01599) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R793654) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-06-10 |