| NPI | 1639596349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18576) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184337) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2022-08-12 |