| NPI | 1982772174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001157793) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024165293) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-06-10 |