| NPI | 1265970057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 61866) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN21934) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2020-11-19 |