| NPI | 1306464607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180739) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001139233) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2023-06-14 |