| NPI | 1053903740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN35356) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1155465) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2024-10-23 |