| NPI | 1245878107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178831) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R205859) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R205859) | |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2022-10-26 |