| NPI | 1346597879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171297) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 337305) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2014-08-19 |