| NPI | 1801909023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024056706) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 00170000562) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |