| NPI | 1639549066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024190144) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9444272) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2025-04-15 |