| NPI | 1114576592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 903418) |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2019-09-08 |