| NPI | 1871504589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 105874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN11736) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2017-02-01 |