| NPI | 1942491865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024167469) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 107992) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-03-03 |