| NPI | 1154897601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN apn0000024016) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902521) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2019-01-31 |