| NPI | 1720671860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180117) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC003411) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-06-01 |