| NPI | 1497966998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19128) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 97945) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166748) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2015-06-09 |