| NPI | 1336903806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024194169) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001295043) |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2025-12-16 |