| NPI | 1811088776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 16927) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP 7284) |
| 363LF0000X Nurse Practitioner Family (Licence: TN APN0000011687) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2021-08-20 |