| NPI | 1164421566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024165784) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0110001871) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2014-08-15 |