| NPI | 1093076887 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024124172)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD AC000146)  | 
| Enumeration Date | 2012-06-07 | 
| Last Update Date | 2012-06-07 |