| NPI | 1063884658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024172834) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001223072) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-03-06 |