| NPI | 1104630227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024192494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 24192494) |
| Enumeration Date | 2025-02-07 |
| Last Update Date | 2025-04-16 |