| NPI | 1962643403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15002) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2024-04-26 |