| NPI | 1689158537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 850051) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2023-04-07 |