| NPI | 1609539444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183095) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024183095) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-11-30 |