| NPI | 1104391580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3012694) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000025328) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2023-08-03 |