| NPI | 1841764586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024176758) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 233305) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2021-10-08 |