| NPI | 1245616457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 30312) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R857002) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2022-04-19 |