| NPI | 1124451893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024171076) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001155115) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2014-05-15 |