| NPI | 1235859604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185188) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 001235788) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-09-12 |