| NPI | 1659312106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 58105) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 58105) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2009-08-05 |