| NPI | 1487652764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN10539) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN10539) |
| 363L00000X Nurse Practitioner (Licence: TN RN142087) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-09-08 |