| NPI | 1265096127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176765) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024176765) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2024-02-21 |