| NPI | 1720464969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN AG0715148) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 20353) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9407584) | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2022-03-11 |