| NPI | 1417352550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024172194) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC002423) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2019-01-04 |