| NPI | 1073147518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179020) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC003068) |
| 163W00000X Registered Nurse (Licence: VA 0001240739) | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-08-28 |