| NPI | 1083234165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001204656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180444) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2021-09-22 |