| NPI | 1578706701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 14134) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012063) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 14134) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2018-03-01 |