| NPI | 1205411220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28824) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015898) |
| 363L00000X Nurse Practitioner (Licence: TN 28824) | |
| 363A00000X Physician Assistant (Licence: TN 28824) | |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2022-11-01 |