| NPI | 1639864200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024186847) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-06-28 |