| NPI | 1912296211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 4136) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15710) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2018-03-30 |