| NPI | 1730471905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 156859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169320) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2020-01-28 |