| NPI | 1649223652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164093) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0017136915) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-12-11 |