| NPI | 1134544596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024174780) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006752) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5006752) | |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2023-08-31 |