| NPI | 1184077158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21299) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174199) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-12-14 |