| NPI | 1104813195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000012066) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 3010162) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2016-07-15 |