| NPI | 1538420054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 17819) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-05-20 |