| NPI | 1407251705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: TN APN19335) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3009034) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: TN 19335) | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2022-03-22 |