| NPI | 1720866262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188114) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 106471) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-02-29 |