| NPI | 1275117996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30648) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO PENDING) |
| Enumeration Date | 2021-05-09 |
| Last Update Date | 2022-03-30 |