| NPI | 1205465986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178059) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178059) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2022-07-21 |