| NPI | 1932377702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R109047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024167148) |
| 363L00000X Nurse Practitioner (Licence: CA 622905) | |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-02-14 |