| NPI | 1164040556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN270795) |
| Enumeration Date | 2020-07-11 |
| Last Update Date | 2024-10-30 |