| NPI | 1639628704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174037) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001165191) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2022-02-16 |