| NPI | 1497768451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN7668) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA LNP24164353) |
| 363L00000X Nurse Practitioner (Licence: VA RN0001086415) | |
| 363L00000X Nurse Practitioner (Licence: VA 0017137018) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |