| NPI | 1154815199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168114) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 69146NP) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2021-10-14 |