| NPI | 1134261837 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171112) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA APO3981) | 
| Enumeration Date | 2007-02-12 | 
| Last Update Date | 2013-12-10 |