| NPI | 1265979876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174288) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP9803) |
| Enumeration Date | 2017-01-21 |
| Last Update Date | 2022-02-24 |