| NPI | 1811974538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0017140181) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001192987) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0017140181) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2018-05-08 |