| NPI | 1770848780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 02140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170105) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2018-12-13 |