| NPI | 1366224578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 001213640) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: VA 0001213640) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2025-10-15 |