| 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 |