| NPI | 1114583630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020110) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001199727) |
| 363L00000X Nurse Practitioner (Licence: VA F05190093) | |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2024-06-25 |