| NPI | 1619256195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024169041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0001082644) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2011-08-15 |