| NPI | 1427646306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180652) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015464) | 
| Enumeration Date | 2021-01-06 | 
| Last Update Date | 2021-01-06 |