| NPI | 1801200506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171841) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18986) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2024-06-06 |