| NPI | 1063196582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187722) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024187722) |
| 163W00000X Registered Nurse (Licence: VA 0001302152) | |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2024-04-01 |