| NPI | 1578717369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000011411) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000055029) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2011-11-14 |