| NPI | 1790063212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000015946) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000015946) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3013613) | |
| 363LF0000X Nurse Practitioner Family (Licence: TN 15946) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2023-04-24 |