| NPI | 1407491095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178472) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024178472) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2021-09-25 |