| NPI | 1316212673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169951) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19716) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2017-01-30 |