| NPI | 1508146523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169540) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001150149) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2016-07-04 |