| NPI | 1407100308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170419) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0017140746) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2016-03-30 |