| NPI | 1083615868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 6089) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 71328) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-04-28 |