| NPI | 1699752311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 140261) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS A810205) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 8428) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2007-10-24 |