| NPI | 1164850020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 27859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000063) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2020-11-09 |