| NPI | 1265580401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024167759) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001179524) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2020-04-02 |