| NPI | 1922074723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 12722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F334485) |
| 163W00000X Registered Nurse (Licence: TN 139899) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2022-03-18 |