| NPI | 1730206129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN FNP8010) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024174104) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2016-11-23 |