| NPI | 1306097845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 52490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902579) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2018-08-27 |