| NPI | 1942607130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 869180) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000019002) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2020-07-21 |