| NPI | 1811028475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN7450) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2023-04-24 |