| NPI | 1376848762 |
|---|---|
| Former Name | VANESSA ELIZABETH FULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA NP20444) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2017-01-11 |