| NPI | 1134049752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IA P57444) |
| 261QV0200X Clinic/Center, VA | |
| Enumeration Date | 2026-07-16 |
| Last Update Date | 2026-07-16 |