| NPI | 1710413612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174783) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22486) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |