| NPI | 1063493815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN RN0000092705) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000006710) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2013-05-09 |