| NPI | 1295076248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178173) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21864) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2020-03-18 |