| NPI | 1952671182 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16667)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 0000106383)  | 
| Enumeration Date | 2012-01-04 | 
| Last Update Date | 2015-03-24 |