| NPI | 1942271457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165361) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001097387) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-01-19 |