| NPI | 1255102273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191891) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030503) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2025-02-10 |