| NPI | 1063245967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024191079) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001245261) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-11-18 |