| NPI | 1912924531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024166065) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0024166065) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-01-12 |