| NPI | 1740857135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 217993) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000029228) |
| Enumeration Date | 2021-06-05 |
| Last Update Date | 2021-08-10 |