| NPI | 1205222676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19835) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902876) |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2018-09-11 |