| NPI | 1306257803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171614) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0024171614) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171614) | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2023-05-04 |