| NPI | 1720722267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184819) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001203572) | 
| Enumeration Date | 2022-04-21 | 
| Last Update Date | 2024-11-21 |