| NPI | 1043366412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024168945) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-102711) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-09-12 |