| NPI | 1467489765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 7463) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN RN0000111855) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2014-05-07 |