| NPI | 1932577236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000021843) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 21843) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 6617-33) | |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2017-10-03 |