| NPI | 1972199966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180825) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA AG09200220) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2022-03-10 |