| NPI | 1063954717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024173956) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173956) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2019-02-04 |