| NPI | 1093122301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18898) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 114986) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172775) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2021-03-08 |