| NPI | 1609501980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186436) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC NP200001680) | 
| Enumeration Date | 2022-07-20 | 
| Last Update Date | 2023-04-24 |