| NPI | 1962921197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174798) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 363LF0000X) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2019-01-24 |