| NPI | 1568985265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175044) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA F07170216) |
| 363L00000X Nurse Practitioner (Licence: NC 5011670) | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2020-07-09 |