| NPI | 1700269289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172709) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: VA 0001155621) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-10-02 |