| NPI | 1114696127 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC NP1051660) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024182642) | 
| Enumeration Date | 2021-09-13 | 
| Last Update Date | 2021-11-09 |