| NPI | 1912498577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 2018007810) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001237120) |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2018-05-19 |