| NPI | 1194108936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN APN19997) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN0000019997) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN PN19997) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2022-03-25 |