| NPI | 1720598915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006653) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175319) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2021-04-17 |