| NPI | 1730742479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 29455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000214051) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2022-06-02 |