| NPI | 1750721726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173742)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9309474)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN217450)  | |
| Enumeration Date | 2013-07-04 | 
| Last Update Date | 2024-05-13 |