| NPI | 1700194008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024168951) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024168951) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2021-07-12 |