| NPI | 1174081905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000025530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25530) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-11-10 |