| NPI | 1730774662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001293629) |
| 363L00000X Nurse Practitioner (Licence: NC 5014416) | |
| 363L00000X Nurse Practitioner (Licence: VA 0024184221) | |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2022-11-07 |