| NPI | 1407092901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: DC RN59279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R117864) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024166545) | |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2013-02-18 |