| NPI | 1699245068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024176971) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024176971) |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2020-02-05 |