| NPI | 1366579872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024110992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024110992) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024110992) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2015-04-23 |