| NPI | 1053813105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024185446) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010338) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2024-04-01 |