| NPI | 1801171640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169717) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007021) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-11-06 |