| NPI | 1609381219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175446) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA F09170634) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2021-08-25 |