| NPI | 1902390982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024176093) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024176093) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2019-12-17 |