| NPI | 1164178349 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-238558)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024183819)  | 
| Enumeration Date | 2022-02-25 | 
| Last Update Date | 2025-05-20 |