| NPI | 1366751414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336212) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2011-09-07 |