| NPI | 1205469517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 3-000521) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024184712) |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2023-05-15 |