| NPI | 1770095762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23579) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000192537) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2018-04-30 |