| NPI | 1861706772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024168915) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024168915) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2019-03-07 |