| NPI | 1376896886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 24171290) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN273550) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2014-07-23 |