| NPI | 1629495247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21526) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171552) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2016-08-19 |