| NPI | 1982966206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177488) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024177488) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP131784) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 207247-6) | |
| Enumeration Date | 2012-06-12 | 
| Last Update Date | 2025-05-09 |