| NPI | 1730465089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16206) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 165696) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2012-01-31 |