| NPI | 1528640414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024182645) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001203046) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2021-12-02 |