| NPI | 1699300855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024186316) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 05905723) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2023-09-27 |