| NPI | 1962824615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175120) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP013564) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2022-03-24 |