| NPI | 1225021199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171902) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 5498) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2015-02-02 |