| NPI | 1164805529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172692) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 00241772692) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-05-17 |