| NPI | 1164414587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN7471)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 81-0108)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: AR A01556ANP)  | |
| Enumeration Date | 2005-08-22 | 
| Last Update Date | 2016-10-18 |