| NPI | 1528599602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 901751) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |