| NPI | 1043611882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171725) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18819) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2017-02-27 |