| NPI | 1972001824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175828) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001222470) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2021-07-08 |