| NPI | 1447594320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17105) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 21974) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 17105) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2022-03-21 |