| NPI | 1912351404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173588) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: VA 0001181340) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-06-13 |