| NPI | 1679211650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 31756) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000222200) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-06-14 |