| NPI | 1245308675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC RN62819) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024142059) |
| 363L00000X Nurse Practitioner (Licence: VA 0001142059) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-06-02 |