| NPI | 1134782691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178178) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001275405) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2022-08-11 |