| NPI | 1053922294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC003520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R101776) |
| 363LF0000X Nurse Practitioner, Family (Licence: AR 125423) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180193) | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2022-05-05 |