| NPI | 1639704786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179561) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001271747) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2022-05-06 |