| NPI | 1376017277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0001325) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-06-19 |