| NPI | 1649767773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024176366) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 0024176366) |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2023-02-24 |