| NPI | 1861816704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000018280) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000171180) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |