| NPI | 1003872623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN12000) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN RN127044) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2020-05-02 |