| NPI | 1215546429 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179906) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001218994) | 
| Enumeration Date | 2020-07-24 | 
| Last Update Date | 2025-06-26 |