| NPI | 1407082423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168330) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 16702) |
| 363L00000X Nurse Practitioner (Licence: KY 3008481) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2016-06-24 |