| NPI | 1245411537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0001199728) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167583) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2014-05-23 |