| NPI | 1982752580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179598) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN210423) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02502) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-19 |