| NPI | 1720574726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176292) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001234356) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005890) | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2022-10-07 |