| NPI | 1376844357 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000015298) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN15298) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2025-02-19 |