| NPI | 1205548724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024186285) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001282151) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2023-01-23 |