| NPI | 1710185079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9436627) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VI 9876) |
| 363L00000X Nurse Practitioner (Licence: VA 0024118550) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2016-07-01 |