| NPI | 1295720720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN RN142096) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 8446) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-04-09 |