| NPI | 1053436295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024167968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001214973) |
| 163W00000X Registered Nurse (Licence: VA 0024167968) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-07-08 |