| NPI | 1801494695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: VA 0024179705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179705) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2024-06-02 |