| NPI | 1891110318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171549) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024171549) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2019-12-30 |