| NPI | 1154683217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175234) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 203490) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2019-06-12 |