| NPI | 1366992851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000021071) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000170732) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-11-12 |