| NPI | 1548521800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171039) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 52023) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2019-07-31 |