| NPI | 1962219931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 264352) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 40117) |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2026-02-02 |