| NPI | 1053900035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024183881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28121186A) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2022-05-27 |