| NPI | 1437136124 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 5301)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 40375)  | 
| Enumeration Date | 2005-12-23 | 
| Last Update Date | 2022-02-16 |