| NPI | 1356423511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DC RN39849) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024166554) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |