| NPI | 1164019410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R227688) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA R227688) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2022-03-11 |