| NPI | 1346693868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173732) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-09-14 |