| NPI | 1790310035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179645) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: VA 0001194958) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2022-11-10 |