| NPI | 1194362657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183978) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 104795) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2024-02-12 |