| NPI | 1497054530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19518) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169282) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2015-05-14 |