| NPI | 1497206601 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174114) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00867400) | 
| Enumeration Date | 2016-10-24 | 
| Last Update Date | 2020-06-29 |