| NPI | 1356756068 |
|---|---|
| Professional Name | SAME AS ABOVE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177654) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024177654) |
| 251E00000X Home Health (Licence: VA 0001214562) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2025-01-09 |