| NPI | 1104368273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187357) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 565088) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2023-06-20 |