| NPI | 1770104556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179344) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179344) |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: VA 0001268912) | |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2020-10-26 |