| NPI | 1710632021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024183917) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA F12210829) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2024-01-30 |