| NPI | 1811374598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30459) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 3376) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-12-10 |