| NPI | 1053987438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024186396) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 209248) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2023-06-22 |