| NPI | 1902596489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187068) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 116000) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |