| NPI | 1942867817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178269) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001240236) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-09-17 |