| NPI | 1114485091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25641) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 192578) |
| Enumeration Date | 2019-03-09 |
| Last Update Date | 2019-03-09 |