| NPI | 1083124325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175533) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 2017011998) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 2017011998) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 2017011998) | |
| Enumeration Date | 2017-09-30 |
| Last Update Date | 2022-03-31 |