| NPI | 1487089322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171094) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 17925) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2015-11-04 |