| NPI | 1407209307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11023944) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017143041) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173740) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2024-04-04 |