| NPI | 1710923362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0017139851) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 100394) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2011-02-22 |