| NPI | 1912477043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024176938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024176938) |
| Enumeration Date | 2018-12-02 |
| Last Update Date | 2025-12-09 |