| NPI | 1104814805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN RN105802) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN RN105802) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN APN 7203) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2023-03-07 |