| NPI | 1861734972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17459) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95017778) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 903352) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2023-05-18 |