| NPI | 1215691563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188829) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 25403) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 25403) | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2024-01-09 |