| NPI | 1871959049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180894) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015839) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 108388) | |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2022-03-16 |