| NPI | 1043860471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179073) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012274) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-03-31 |