| NPI | 1558364620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN 6043) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164897) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-09-22 |