| NPI | 1811170517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13647) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2009-02-14 |