| NPI | 1134463292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024177516) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R201499) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2023-07-25 |