| NPI | 1154575272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166867) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2277584) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2016-02-01 |