| NPI | 1699147967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11002216) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA F1015498) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2019-09-05 |