| NPI | 1922408970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172002)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC005384)  | 
| Enumeration Date | 2014-08-27 | 
| Last Update Date | 2023-05-22 |