| NPI | 1619383114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 18880) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 128900) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2024-01-28 |