| NPI | 1972787489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: DC RN65944) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 24136572) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |