| NPI | 1700548492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024190610) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5015198) |
| 363L00000X Nurse Practitioner (Licence: NY F310292) | |
| Enumeration Date | 2021-10-10 |
| Last Update Date | 2024-08-29 |