| NPI | 1013803618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024193955) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001294701) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024193955) | |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-07-07 |