| NPI | 1194079764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 26728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 822120) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2021-08-05 |