| NPI | 1063053254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN000026288) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN000026288) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2026-01-21 |