| NPI | 1477917136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024173631) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: VA 0134899) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-07-05 |