| NPI | 1104083120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164592) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2013-01-28 |