NPI | 1487435376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0024188699) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 0024188699) |
363LC1500X Nurse Practitioner, Community Health (Licence: VA 0024188699) | |
Enumeration Date | 2023-10-09 |
Last Update Date | 2025-10-07 |