| NPI | 1104191055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R200653) |
| Enumeration Date | 2012-03-11 |
| Last Update Date | 2019-08-19 |