| NPI | 1306068762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024153108) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001153108) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-09-11 |