| NPI | 1205059839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 14583) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 128750) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2011-11-23 |