| NPI | 1962921650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175316) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0024175316) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2019-03-08 |