| NPI | 1679206494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC004894) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185926) |
| 163W00000X Registered Nurse (Licence: VA 0001238969) | |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2023-01-30 |