| NPI | 1508262809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 29227) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172304) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC001432) | |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2022-03-18 |