| NPI | 1609103241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024175024) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 778221) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2020-09-04 |