| NPI | 1124653589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0024179589) |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2022-08-16 |