| NPI | 1861982738 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176112)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001233942)  | 
| 363L00000X Nurse Practitioner (Licence: VA 0024176112)  | |
| Enumeration Date | 2018-05-15 | 
| Last Update Date | 2024-10-10 |