| NPI | 1700227196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R861102) |
| Enumeration Date | 2013-07-13 |
| Last Update Date | 2016-11-10 |