| NPI | 1790051910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178891) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 337212) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 1292471) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2024-08-20 |