| NPI | 1174771349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 20396) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 934) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2015-12-10 |