| NPI | 1679167696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181539) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9525534) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-08-18 |