| NPI | 1306226618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: VA 0001070569) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001201422) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2019-07-09 |