| NPI | 1730173261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 7223) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 179647) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 179647) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN7223) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-04-09 |