| NPI | 1255774261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 165512) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 17455) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2019-05-14 |