| NPI | 1093422842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5022047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024185686) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5022047) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185686) | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2025-07-10 |