| NPI | 1043755861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024174983) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0017144062) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2019-03-20 |