| NPI | 1063487452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024164363P) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001140571) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-03-17 |