| NPI | 1134680663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 27067) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011626) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2021-06-15 |