| NPI | 1003858150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000005691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN5691) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-10-12 |