| NPI | 1952463549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164531) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001083670) | 
| Enumeration Date | 2006-12-14 | 
| Last Update Date | 2012-12-06 |