| NPI | 1255394003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164292) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008632) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2016-09-08 |