| NPI | 1912964115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175379) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 044353-23-03) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2019-07-31 |