| NPI | 1235513508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19824) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172562) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2017-05-09 |