| NPI | 1568538809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024064692) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001064692) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-11-12 |