| NPI | 1891349643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30475) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 206977) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-08-24 |