| NPI | 1104166016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000019079) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TN 152367) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2018-06-11 |