| NPI | 1548664360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175562) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 61884) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2024-04-25 |