| NPI | 1609942838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0001150236) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024164022) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2012-01-26 |