| NPI | 1588294730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 27540) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012715) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-12-09 |