| NPI | 1093165102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21497) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 187827) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173941) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-10-14 |