| NPI | 1093190373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000019399) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000019399) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2018-12-11 |