| NPI | 1811404122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024180007) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001204598) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2022-01-27 |