| NPI | 1629096847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168335) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 275851) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-09-03 |