| NPI | 1629442694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173176) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20561) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2017-02-06 |