| NPI | 1962100784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33575) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 99999) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-04-04 |