| NPI | 1063755502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17524) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 149495) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024192942) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2025-04-07 |