| NPI | 1720852924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188678) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024188678) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-12-22 |