| NPI | 1972121127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29178) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 215795) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-03-22 |