| NPI | 1861982738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024176112) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001233942) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024176112) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-05-15 |