| NPI | 1114574753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178146) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012113) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2026-05-13 |