| NPI | 1629382502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001203852) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2011-02-03 |