| NPI | 1154921120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28465) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180350) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |