| NPI | 1346965324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017034) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC HAST-TN20P) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC HAST-TN20P) | |
| Enumeration Date | 2022-10-11 | 
| Last Update Date | 2022-10-11 |