| NPI | 1114911138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000005854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 02414P) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2007-07-08 |