| NPI | 1659742450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173012) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024173012) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2024-11-20 |