| NPI | 1639826852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R271561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL AC004201) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183900) | |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2026-02-05 |