| NPI | 1710557079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN NA) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2022-07-25 |