| NPI | 1952609463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15691) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170885) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2013-07-17 |