| NPI | 1023085800 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024076754) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001076754) | 
| Enumeration Date | 2006-03-01 | 
| Last Update Date | 2014-09-16 |