| NPI | 1154814697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0110006241) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2021-07-19 |