| NPI | 1396106340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9449258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA APPLIED FOR) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2019-04-08 |