| NPI | 1174171631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5012175) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012175) |
| 363L00000X Nurse Practitioner (Licence: VA 0024178011) | |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024178011) | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2024-02-06 |