| NPI | 1356625164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010664) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000016096) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2022-02-08 |