| NPI | 1124382593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012007171) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169754) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2019-08-22 |