| NPI | 1790877694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024166727) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001175487) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-07-27 |