| NPI | 1376349795 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001149433) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: VA 0001149433) |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2025-02-25 |