| NPI | 1063508638 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164074) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002526) | 
| 363LF0000X Nurse Practitioner, Family (Licence: DC RN1039075) | |
| Enumeration Date | 2006-10-04 | 
| Last Update Date | 2019-01-07 |