| NPI | 1760957278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0024176955) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 2018007490) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2023-02-15 |