| NPI | 1497790554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000017752) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 2952) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-01-06 |