| NPI | 1578765772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 98501) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000012790) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-04-23 |