| NPI | 1619486123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175155) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001240900) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2021-10-01 |