| NPI | 1043550056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172167) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN170078) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2015-02-23 |