| NPI | 1164427142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179311) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0024179311) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 24179311) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-11-23 |