| NPI | 1356408561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024079056) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0017001113) |
| 363L00000X Nurse Practitioner (Licence: VA 0001079056) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2021-06-03 |