| NPI | 1457771040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000018007) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000149679) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |