| NPI | 1891996211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024172090) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-08-19 |