| NPI | 1356883235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23423) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174145) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2018-01-25 |