| NPI | 1760905608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175530) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001187556) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2022-07-21 |