| NPI | 1578074910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22975) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 189646) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN F06172610) | |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-06-16 |