| NPI | 1407009251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169954) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001236204) |
| 363L00000X Nurse Practitioner (Licence: PA RN285740L) | |
| 363L00000X Nurse Practitioner (Licence: PA SP010069) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2020-09-17 |