| NPI | 1679949572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024181453) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024181453) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 20282) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2022-01-11 |