| NPI | 1063260875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024190322) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 2024007071) |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2025-11-25 |