| NPI | 1366809139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19966) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20666) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2021-06-11 |