| NPI | 1164830543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18956) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134169) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 218942) | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2022-01-04 |