| NPI | 1649651720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 363LFOOOOX) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000020198) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2016-04-13 |