| NPI | 1053918847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001232312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0001232312) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-11-02 |