| NPI | 1740655091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20927) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 901379) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2016-03-10 |