| NPI | 1457860157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175452) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002146) | 
| Enumeration Date | 2017-09-25 | 
| Last Update Date | 2024-07-10 |