| NPI | 1104940212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024164652) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024164652) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-11-25 |