| NPI | 1134414287 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177020) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9324292) | 
| Enumeration Date | 2011-06-16 | 
| Last Update Date | 2019-08-26 |