| NPI | 1972159028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177894) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001223402) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |