| NPI | 1184929614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A187772) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704433182) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 6571483) | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2025-11-03 |