| NPI | 1154803666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 24843) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: AL AG09170078) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-12-12 |