| NPI | 1790780856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001030024) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164028) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2023-03-07 |