| NPI | 1134756802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178855) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024178855) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2021-04-28 |