| NPI | 1568906188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009120) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2021-01-13 |