| NPI | 1609100536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000014274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A03268ANP) |
| 363LF0000X Nurse Practitioner Family (Licence: MS A810398) | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2011-04-04 |