| NPI | 1710039425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 0017000701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017000701) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-08-04 |