| NPI | 1104456052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 23362) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: TN 23362) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2024-04-18 |