| NPI | 1124002035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168638) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 14888) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2017-02-07 |