| NPI | 1922491349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 7036) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000019463) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9415721) | |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2022-07-21 |