| NPI | 1235529256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21713) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F0115828) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2016-11-01 |