| NPI | 1376792192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 13402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS A810389) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 13402) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2019-09-19 |