| NPI | 1629168315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169362) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH NR063654) |
| 363L00000X Nurse Practitioner (Licence: NJ NN063654) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-01-22 |