| NPI | 1972812147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024168993) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001227047) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2022-12-19 |