| NPI | 1194172726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024173383) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019005354) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024173383) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024173383) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2025-03-14 |