| NPI | 1164695227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 102692) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168075) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2015-11-11 |