| NPI | 1629309059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024176279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R872356) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2020-09-21 |