| NPI | 1689740896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024042360) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001042360) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2012-01-05 |