| NPI | 1942885553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 254782) |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2024-05-21 |