| NPI | 1104879329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN7987) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS A810172) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-11-05 |