| NPI | 1407256910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000022276) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5926) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 5926-33) | |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2022-03-22 |