| NPI | 1215485966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175637) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 6694) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 6694) | |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2021-08-11 |