| NPI | 1912313370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171864) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338965) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2017-04-04 |