| NPI | 1063978948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 26165) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 146130) |
| 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: TN 70) | |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2022-04-12 |