| NPI | 1528053022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN RN47596) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 5467) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-08-07 |