| NPI | 1639154099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024168384) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: LA 03643) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2018-03-17 |