| NPI | 1255731071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171929) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001249978) |
| 163W00000X Registered Nurse (Licence: IL 041378889) | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2016-03-16 |