| NPI | 1912174855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167755) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024167755) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2013-06-06 |