| NPI | 1205000718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172990) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 3464314405) |
| 363L00000X Nurse Practitioner (Licence: UT 3464314405) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2015-12-15 |