| NPI | 1568459675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024078407) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 062263-23) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2012-05-27 |