| NPI | 1063642718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 14110) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000014110) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2020-08-11 |