| NPI | 1902151095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16791) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R881642) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2015-03-30 |