| NPI | 1043864564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011843) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2024-05-24 |