| NPI | 1255725016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178685) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 586622-1) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2021-12-10 |