| NPI | 1659587350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024131840) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001131840) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |