| NPI | 1306463120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024189310) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000240695) |
| 363L00000X Nurse Practitioner (Licence: MA F10201084) | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2024-04-03 |