| NPI | 1982263620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178766) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 25148) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-06-10 |