| NPI | 1003989351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024166276) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 007138155) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2015-02-20 |