| NPI | 1871584102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001165944) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165238) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2021-12-02 |