| NPI | 1649914516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0021484249) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001294238) |
| 363L00000X Nurse Practitioner (Licence: VA 0024184249) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5016193) | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-10-21 |