| NPI | 1558451187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165860) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 55352) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-02-20 |