| NPI | 1659479913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173566) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001263114) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 333363) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-09-15 |