| NPI | 1619251626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 16361) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2013-01-10 |