| NPI | 1972618700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000006029) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN0000006029) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2017-11-15 |