| NPI | 1104894641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000007340) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000007340) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TN APN0000007340) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2013-06-05 |