| NPI | 1689233264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 00000025509) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-04-06 |