| NPI | 1750846309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 225566) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 744) | |
| 363L00000X Nurse Practitioner (Licence: KY 3014725) | |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2024-06-02 |