| NPI | 1376164533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001249315) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-10-19 |