| NPI | 1376062695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024175444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0001275767) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2021-02-23 |