| NPI | 1972042596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD 2016016265) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2022-09-23 |