| NPI | 1780144246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 289278) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2020-12-21 |