| NPI | 1679832414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170042) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017140472) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2023-06-29 |