| NPI | 1154311520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001069785) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024069785) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024069785) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2008-03-14 |