| NPI | 1487385829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024184370) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001267488) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184370) | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-10-20 |