| NPI | 1417351891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 170938) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19233) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173541) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2016-06-23 |