| NPI | 1649558255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169482) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001212724) |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2011-07-31 |