| NPI | 1891931069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 810545) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012019851) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000013748) | |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2019-02-04 |