| NPI | 1598075194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170032) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R092480) | 
| Enumeration Date | 2010-10-15 | 
| Last Update Date | 2012-06-22 |