| NPI | 1639782659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179647) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024179647) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-01-04 |