| NPI | 1194504068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024187872) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0024187872) | |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |