| NPI | 1386988665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170501) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2018-03-17 |