| NPI | 1265732515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R870953) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173270) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2020-08-26 |