| NPI | 1104078468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-104224) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN PENDING) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2020-11-12 |