| NPI | 1124666078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180182) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001231524) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2020-09-25 |