| NPI | 1962775999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN16491) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 16491) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2014-07-30 |