| NPI | 1962596809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN apn0000011973) | 
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: TN apn0000011973) | 
| Enumeration Date | 2006-10-03 | 
| Last Update Date | 2011-09-13 |