| NPI | 1760661821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 810321) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000012958) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4028636) | |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2025-01-30 |