| NPI | 1134505134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC001571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172771) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |