| NPI | 1972597151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15103) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171834) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2018-06-04 |