| NPI | 1770176851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190246)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009015)  | 
| Enumeration Date | 2021-02-18 | 
| Last Update Date | 2024-08-18 |