| NPI | 1174954697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024171346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171346) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2017-06-22 |