| NPI | 1417309907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024173864) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001217039) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0001217039) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-07-25 |