| NPI | 1861554453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024121324) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001121324) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2011-12-29 |