| NPI | 1760459226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0017139446) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 3256232) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: FL 3256232) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2009-08-19 |