| NPI | 1245815596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 904559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 29086) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-04-20 |