| NPI | 1851317663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169576) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 11328) |
| 363L00000X Nurse Practitioner (Licence: SC 22019) | |
| 363L00000X Nurse Practitioner (Licence: TN APN0000011328) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-09-28 |