| NPI | 1477001055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 21732) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 432282) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2022-03-10 |