| NPI | 1629379789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169011) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001117856) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2014-02-03 |