| NPI | 1851062335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183381) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN671243) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2022-01-21 |