| NPI | 1639686645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177027) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R226430) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2022-01-07 |