| NPI | 1679909766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 164279) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 17893) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2023-11-13 |