| NPI | 1871593111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 97013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 97013) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 0000006857) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2007-07-08 |