| NPI | 1770532582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS A810030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN05604) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TN APN5604) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MS A810030) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2017-03-24 |