| NPI | 1942249743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN7432) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN RN0000110919) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2009-11-23 |