| NPI | 1154608859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30794) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-116290) |
| 363LS0200X Nurse Practitioner, School (Licence: TN 30794) | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2025-03-05 |