| NPI | 1316053457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171254) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 332265) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-01-22 |