| NPI | 1295723039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA UP001347B) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2014-10-08 |