| NPI | 1073957023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 40444) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2020-12-16 |