| NPI | 1366873994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 00241170478) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001240919) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0017141299) | |
| Enumeration Date | 2013-12-08 |
| Last Update Date | 2013-12-08 |