| NPI | 1790196111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171849) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001174230) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2024-12-10 |