| NPI | 1528216405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 8078) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN RN00000128007) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2021-07-21 |