| NPI | 1205395001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25586) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011599) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-10-03 |