| NPI | 1992469654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024188362) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001287772) |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2023-10-03 |