| NPI | 1174992382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009798) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2025-12-03 |