| NPI | 1871021089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175534) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 00000000000000000000) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2021-07-30 |