| NPI | 1558350520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN11686) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN APN0000011686) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2011-05-24 |