| NPI | 1053635557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN14897) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN RN168740) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-03-26 |