| NPI | 1760077663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001176322) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2021-12-27 |