| NPI | 1417425257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29511) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-096591) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-096591) | |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2021-10-06 |