| NPI | 1174903678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC002923) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001217042) |
| 363L00000X Nurse Practitioner (Licence: VA 0024172559) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2021-04-01 |