| NPI | 1750982401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024179884) |
| Enumeration Date | 2020-11-07 |
| Last Update Date | 2022-05-18 |