| NPI | 1053468371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024150690) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN63125) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |