| NPI | 1063929289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN F10170142) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000210926) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2019-08-06 |