| NPI | 1780009977 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000017999)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000141528)  | 
| Enumeration Date | 2014-02-25 | 
| Last Update Date | 2014-02-25 |