| NPI | 1720793961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186219) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024186219) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-11-08 |