| NPI | 1417347451 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172315) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024172315) | 
| Enumeration Date | 2015-01-29 | 
| Last Update Date | 2024-01-18 |