| NPI | 1114902855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC RN9662299) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC RN966229) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166703) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2009-05-28 |