| NPI | 1750639605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173512) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-072891) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2021-10-12 |