| NPI | 1265769293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN pending number) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 14552) |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2011-03-08 |