| NPI | 1760462303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 104402) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 104402) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2011-07-20 |