| NPI | 1235419268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169457) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001187672) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2023-08-11 |