NPI | 1205137569 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 15233) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 94637) |
Enumeration Date | 2010-11-03 |
Last Update Date | 2016-10-10 |