| NPI | 1962757195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189783) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 183052) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-04-11 |