| NPI | 1649516170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000020536) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 179874) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2016-01-22 |