| NPI | 1679954069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR r105081) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 24414) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2020-04-06 |