| NPI | 1962179994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181698) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001247316) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2022-09-26 |