| NPI | 1902146376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000111005) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2014-06-16 |