| NPI | 1932575958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 20506) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 169201) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024173100) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2021-01-21 |