| NPI | 1619096807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN05721) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 5721) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-01-06 |