| NPI | 1255316238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN RN142755) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN8452) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-07-08 |