| NPI | 1104042555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024097886) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: VA 2006011232) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2026-08-21 |