| NPI | 1336712595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182306) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 2021031910) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-10-22 |