| NPI | 1760675912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: DC RN60205) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024103261) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |