| NPI | 1831436765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000017177) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17177) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2021-04-22 |