| NPI | 1639640949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA SP019785) |
| 363L00000X Nurse Practitioner (Licence: PA SP019785) | |
| Enumeration Date | 2018-12-13 |
| Last Update Date | 2020-08-06 |