| NPI | 1124644232 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179676)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001240964)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179676)  | |
| Enumeration Date | 2020-06-24 | 
| Last Update Date | 2023-02-02 |