| NPI | 1982966206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024177488) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131784) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 207247-6) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-08-11 |