| NPI | 1861475204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA A03703) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 453123) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2024-09-13 |