| NPI | 1730794090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA F09200240) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2021-05-12 |