| NPI | 1568748564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169232) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC001193) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2018-06-01 |