| NPI | 1316412141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176860) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 101349) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2021-03-12 |