| NPI | 1710369590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172846) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19992) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-10-13 |