| NPI | 1952300170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178286) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 088814) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2019-10-28 |