| NPI | 1508203621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 91168) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2015-06-11 |