| NPI | 1306064308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704300983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN135786) |
| 363LF0000X Nurse Practitioner Family (Licence: TN APN11882) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-02-09 |