| NPI | 1417959727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN6294) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024126669) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-07-14 |