| NPI | 1225013139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167698) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA UP006027-B) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2013-06-04 |