| NPI | 1346645389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172154) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2018-09-18 |