| NPI | 1720525561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024180289) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 341352) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2024-10-23 |