| NPI | 1083057012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024171073) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 76215) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2021-04-14 |