| NPI | 1790996361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024070694) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024070694) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-10-16 |