| NPI | 1760499040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R879247) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165301) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-01-18 |