| NPI | 1801827373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29746) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN PTA3149) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-10-26 |