NPI | 1073515136 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN8107) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4230P) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2023-03-07 |