| NPI | 1770994972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18593) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007059) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007059) | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-05-02 |