| NPI | 1467004010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 23387) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000023387) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175468) | |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2019-09-23 |