| NPI | 1780941831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171615) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 51009) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2022-08-01 |