| NPI | 1003377805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180237) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001231806) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2022-12-29 |