| NPI | 1629555727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176309) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 11963220-4405) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2021-04-13 |