| NPI | 1902438930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 345488) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2021-08-25 |