| NPI | 1922439017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024170742) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001172804) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2014-01-07 |