NPI | 1790059251 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN17328) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-115466) |
Enumeration Date | 2012-03-01 |
Last Update Date | 2022-03-29 |