| NPI | 1174962575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006668) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2019-08-08 |