| NPI | 1265811533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172795) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 207789) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2021-06-09 |