| NPI | 1760629547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 16932) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011165) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5004266) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2020-08-25 |