| NPI | 1669602314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169354) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017140070) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2011-06-14 |