| NPI | 1205974649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 11309) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 810553) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-09-15 |