| NPI | 1356811863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024176798) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 25138) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2020-03-26 |