| NPI | 1558761148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 19085) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 901277) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2021-12-06 |