| NPI | 1215225073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15798) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2020-10-13 |