| NPI | 1679958995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-58574) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN20121) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2020-01-10 |